Managing pain in practice - 2010

The debate about NSAIDs
Andrew Moore
pp 1-3
How well is pain treated? Absolutely awfully. The record is dismal, whether it is acute pain in hospital or chronic pain in the community. The Pain in Europe survey (, to take the largest example, found that one in five of 50,000 adults had pain of moderate intensity or worse, almost daily, and lasting more than six months; for half, pain has lasted ten years or more. They thought their treatment was poor.
What is pain? Examining what we feel
Dominic Aldington
pp 4-5
Pain is certainly not just nociception – the neural processing of ‘noxious’ stimuli. Nor is it just one thing – despite the fact that we use the same word for many types of pain. Thus, if we catch our finger in a drawer we will describe a pain. However, this is clearly very different to the pain of childbirth, which in turn is different to phantom limb pain, which in turn is different to chronic low back pain.
Comment: A new focus on a complex issue
Dominic Aldington
pp 5-5
As befits the inaugural editorial in the first edition of any journal, I would like to thank you for reading thus far. I would also like to take the opportunity to tell you a little more about our aims for Managing pain in practice (MPIP). The journal has been developed with the primary focus of providing information to healthcare professionals on the current thinking and practice in the management of pain.
The challenge of prescribing – and patient adherence – in medication management
Norman Evans
pp 6-7
Despite the use of medicines being the most common healthcare intervention, patients do not always use them in the way the prescriber intended. This can result in ill health, which could have been avoided, and waste.
A three-pot system for the pain ladder
Henry McQuay
pp 8-8
Sacrificing some precision for the sake of clarity, one can argue that for all nociceptive pain we use the same range of analgesics, from paracetamol through to morphine. In acute pain, we may start with the strongest and move to less potent drugs as the pain abates. In chronic pain, we may start with the less potent and move to the strongest if the pain becomes more severe.
Diagnosing, treating and managing the pain arising from osteoarthritis: part 1
John Dickson
pp 9-11
Osteoarthritis (OA) is a painful, functionally limiting joint condition, mostly affecting the over-45s, which impairs quality of life. While OA is rarely seen before the age of 45, it is the most common cause of disability in those over the age of 65. Hip and/or knee OA affect 20% of the older population.